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Three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial
BACKGROUND: Manual therapy as spinal manipulation, spinal mobilization, stretching and massage are common treatment methods for neck and back pain. The objective was to compare the treatment effect on pain intensity, pain related disability and perceived recovery from a) naprapathic manual therapy (...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842267/ https://www.ncbi.nlm.nih.gov/pubmed/27107960 http://dx.doi.org/10.1186/s12891-016-1030-y |
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author | Paanalahti, Kari Holm, Lena W. Nordin, Margareta Höijer, Jonas Lyander, Jessica Asker, Martin Skillgate, Eva |
author_facet | Paanalahti, Kari Holm, Lena W. Nordin, Margareta Höijer, Jonas Lyander, Jessica Asker, Martin Skillgate, Eva |
author_sort | Paanalahti, Kari |
collection | PubMed |
description | BACKGROUND: Manual therapy as spinal manipulation, spinal mobilization, stretching and massage are common treatment methods for neck and back pain. The objective was to compare the treatment effect on pain intensity, pain related disability and perceived recovery from a) naprapathic manual therapy (spinal manipulation, spinal mobilization, stretching and massage) to b) naprapathic manual therapy without spinal manipulation and to c) naprapathic manual therapy without stretching for male and female patients seeking care for back and/or neck pain. METHOD: Participants were recruited among patients, ages 18–65, seeking care at the educational clinic of Naprapathögskolan - the Scandinavian College of Naprapathic Manual Medicine in Stockholm. The patients (n = 1057) were randomized to one of three treatment arms a) manual therapy (i.e. spinal manipulation, spinal mobilization, stretching and massage), b) manual therapy excluding spinal manipulation and c) manual therapy excluding stretching. The primary outcomes were minimal clinically important improvement in pain intensity and pain related disability. Treatments were provided by naprapath students in the seventh semester of eight total semesters. Generalized estimating equations and logistic regression were used to examine the association between the treatments and the outcomes. RESULTS: At 12 weeks follow-up, 64 % had a minimal clinically important improvement in pain intensity and 42 % in pain related disability. The corresponding chances to be improved at the 52 weeks follow-up were 58 % and 40 % respectively. No systematic differences in effect when excluding spinal manipulation and stretching respectively from the treatment were found over 1 year follow-up, concerning minimal clinically important improvement in pain intensity (p = 0.41) and pain related disability (p = 0.85) and perceived recovery (p = 0.98). Neither were there disparities in effect when male and female patients were analyzed separately. CONCLUSION: The effect of manual therapy for male and female patients seeking care for neck and/or back pain at an educational clinic is similar regardless if spinal manipulation or if stretching is excluded from the treatment option. TRIAL REGISTRATION: Current Controlled Trials ISRCTN92249294 |
format | Online Article Text |
id | pubmed-4842267 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-48422672016-04-25 Three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial Paanalahti, Kari Holm, Lena W. Nordin, Margareta Höijer, Jonas Lyander, Jessica Asker, Martin Skillgate, Eva BMC Musculoskelet Disord Research Article BACKGROUND: Manual therapy as spinal manipulation, spinal mobilization, stretching and massage are common treatment methods for neck and back pain. The objective was to compare the treatment effect on pain intensity, pain related disability and perceived recovery from a) naprapathic manual therapy (spinal manipulation, spinal mobilization, stretching and massage) to b) naprapathic manual therapy without spinal manipulation and to c) naprapathic manual therapy without stretching for male and female patients seeking care for back and/or neck pain. METHOD: Participants were recruited among patients, ages 18–65, seeking care at the educational clinic of Naprapathögskolan - the Scandinavian College of Naprapathic Manual Medicine in Stockholm. The patients (n = 1057) were randomized to one of three treatment arms a) manual therapy (i.e. spinal manipulation, spinal mobilization, stretching and massage), b) manual therapy excluding spinal manipulation and c) manual therapy excluding stretching. The primary outcomes were minimal clinically important improvement in pain intensity and pain related disability. Treatments were provided by naprapath students in the seventh semester of eight total semesters. Generalized estimating equations and logistic regression were used to examine the association between the treatments and the outcomes. RESULTS: At 12 weeks follow-up, 64 % had a minimal clinically important improvement in pain intensity and 42 % in pain related disability. The corresponding chances to be improved at the 52 weeks follow-up were 58 % and 40 % respectively. No systematic differences in effect when excluding spinal manipulation and stretching respectively from the treatment were found over 1 year follow-up, concerning minimal clinically important improvement in pain intensity (p = 0.41) and pain related disability (p = 0.85) and perceived recovery (p = 0.98). Neither were there disparities in effect when male and female patients were analyzed separately. CONCLUSION: The effect of manual therapy for male and female patients seeking care for neck and/or back pain at an educational clinic is similar regardless if spinal manipulation or if stretching is excluded from the treatment option. TRIAL REGISTRATION: Current Controlled Trials ISRCTN92249294 BioMed Central 2016-04-23 /pmc/articles/PMC4842267/ /pubmed/27107960 http://dx.doi.org/10.1186/s12891-016-1030-y Text en © Paanalahti et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Paanalahti, Kari Holm, Lena W. Nordin, Margareta Höijer, Jonas Lyander, Jessica Asker, Martin Skillgate, Eva Three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial |
title | Three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial |
title_full | Three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial |
title_fullStr | Three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial |
title_full_unstemmed | Three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial |
title_short | Three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial |
title_sort | three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4842267/ https://www.ncbi.nlm.nih.gov/pubmed/27107960 http://dx.doi.org/10.1186/s12891-016-1030-y |
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